r/CaliforniaWorkComp

Heres what happened:

I work at a a dog facility. I was bit by a dog while at work. it was small but deep and i was in pain and bleeding. i didnt know what to do so i just went to urgent care through my insurance. i told them it happened at work. they gave me a bandage with antibiotics, prescribed me antibiotics and pain meds. My boss did not send me any form to file any claims. They also didnt seem very concerned about it. It has been a week now and then bite is healing but my hand still hurts during certain movements. I just want to get my bases covered. What can I do if my boss isnt trying to move forward with this? I also almost feel like they are avoiding it and will be annoyed if I follow through with a claim. Help plz!!

Location: California

Wrote a new article this week and figured I'd share the highlights here since this comes up in almost every consult.

After a work injury, the insurance company's claims adjuster is going to call you. They'll sound helpful. They might even say they want to "get you taken care of." Most injured workers assume the adjuster is on their side. They're not.

Then a few weeks after speaking to the examiner, shock, when the denial is received in the mail.

Your employer pays the workers' comp premiums. It works like car insurance. More claims paid out means premiums go up the next year. So the adjuster has two jobs. Investigate fairly under CCR 10109, and protect the insurance company and employer from paying out more than what's actually owed. Those two duties pull in opposite directions, and in practice the second one usually wins.

A few things worth knowing:

Talk about THIS injury. Nothing else. When the adjuster calls, give them the basic facts of what happened. When did it occur? What were you doing? What body parts are affected? Where did you get first treatment? That's the conversation. You are not obligated to give them a medical autobiography.

Do not sign a blanket medical release. This is the biggest trap and where injured workers lose ground without realizing it. The adjuster will ask for your full medical history going back years. Every doctor, every complaint, every MRI. They are not doing this to help you. They are looking for any prior injury or old complaint they can use to argue your current problem is pre-existing.

If you had a back complaint five years ago and you're now claiming a back injury at work, that old record is going to come back at you at the QME and at trial. The more medical history you hand over, the more ammunition they have to deny or minimize your claim.

You're required to submit to reasonable medical evaluations and cooperate with the investigation. You are not required to give them a blank check to every doctor you've ever seen. If the adjuster tells you the claim cannot move forward without the signed authorization, that is not accurate.

I always will revoke any blanket authorization if one was signed before I cam onto the case.

If they deny, you have the right to a QME. The insurance company is banking on you not knowing that. The QME process is one of the most important stages of any case and it's where unrepresented workers lose the most ground.

The adjuster isn't necessarily a bad person. They're doing a job. But their incentives are aligned with the insurance company, not with you. Be polite, give them the facts of THIS injury, and don't volunteer your medical history.

Never lie to doctors when asked about your history. Ever. However, there is a difference between being truthful during a medical examination and volunteering information to a claims examiner when the information is not relevant to them accepting your case.

For deeper dive check the article linked here. Questions, drop em in the comments below.

- Fishmango

I asked my manager several times if I could go see a doctor after I was bitten by a dog at work. She never answered. Blew me off on multiple occasions. I filed a work comp claim.

The owners called me to settle and have them write me a check if I “cancelled the work comp claim” I was frightened, not going to lie. Felt harassed. The owners called me. He’s never called me before. I’ve worked here for 3 years.

Now what? Can she fire me..?

Please help. Let me know about your experience. Greatly appreciate you!!

My injuries were initially denied and after months of delays , and after getting MRI’s done it’s obvious I need surgery and so now there’s a process to get that approved and they are just starting to address other body parts that got injured during a fall after months since the injury , getting those MRI’s and seeing specialists . some of which have gotten a lot worse without proper treatment and trying to treat them myself at home . Peoples injuries can significantly get worse while being denied treatment . Then there’s bigger problems gees .